Miscarriage is when a fetus stops growing and dies before 20 weeks of pregnancy. In Australia, if it isn’t clear how far along a pregnancy is, doctors will call it a miscarriage if the fetus weighs less than 400 gm.
Miscarriages happen in about one in five confirmed pregnancies, usually in the first 12 weeks. Miscarriage can happen before you find out you’re pregnant.
Anyone can have a miscarriage – even if you’re fit and healthy. Miscarriage happens for many different reasons. Usually it’s because the fetus isn’t developing properly. Once a miscarriage begins, no medical treatment can stop it.
In Australia miscarriage means that a pregnancy has ended before 20 weeks. Pregnancy loss after 20 weeks is referred to as stillbirth.
Symptoms of a miscarriage
Miscarriage can happen suddenly or over a few days or weeks, and symptoms can differ among women.
The most common symptom of a miscarriage is vaginal bleeding. The bleeding can be light or heavy. There might also be blood clots.
You might also experience other symptoms like cramps in your lower tummy, similar to period pain.
There’s nothing you or a doctor or midwife can do once a miscarriage has begun. But if you think you’re having a miscarriage, you need medical attention, so it’s important to call your doctor or midwife.
A miscarriage is usually confirmed when an ultrasound scan can no longer detect a baby’s heartbeat.
Vaginal bleeding doesn’t always mean that a miscarriage is happening. But you should see your doctor or midwife straight away if you notice any vaginal bleeding during your pregnancy. The doctor or midwife can diagnose miscarriage or check that your pregnancy is still progressing as expected.
After a miscarriage: what to expect
Pregnancy tissue often passes naturally on its own within a few days, but it might take up to two weeks. While this is happening, you might notice heavier bleeding and period cramps.
Use sanitary pads rather than tampons to manage the bleeding in the first few days after a miscarriage. This helps to prevent infection.
You can take paracetamol or ibuprofen to manage any pain.
If you don’t want to wait for the pregnancy tissue to pass naturally, you can consider medication or a dilatation and curettage (D&C). A D&C is a surgical procedure that gently scrapes away any tissue still lining the uterus after a miscarriage.
Your doctor or midwife can help you decide on the safest and best option for you.
Complications after miscarriage
Sometimes women have complications after a miscarriage, usually when the pregnancy tissue doesn’t pass on its own.
You need to see a doctor immediately if:
- your bleeding gets heavier
- you have a lot of pain
- you have signs of an infection – for example, a bad smell from the vaginal bleeding, fever or nausea.
It’s important to see your GP or midwife if:
- your miscarriage was confirmed but you haven’t passed any pregnancy tissue after two weeks
- your bleeding and pain get worse.
If you’re having complications, GPs and midwives might suggest medication or a D&C.
Your feelings after miscarriage
Miscarriage affects your emotions as well as your body.
A miscarriage can bring up intense feelings of grief, emptiness, sadness, anger, anxiety and depression. A miscarriage can be shocking and devastating because you’ve lost not only a pregnancy but also your hopes and dreams of becoming a parent or of having another child.
Many parents want answers about how and why the miscarriage happened. It’s hard, because often there’s no clear reason for the miscarriage.
There’s no right way to feel or grieve after your miscarriage. This experience is different for everyone, and everyone grieves differently and in their own time.
Partners: different experiences of grief after miscarriage
You and your partner might experience or express grief differently.
For example, some people might find it hard to say how they feel but might exercise or work more as a way of letting out their grief. Some people might not like talking about the miscarriage with others. And sometimes the partners of women who’ve had miscarriages might feel that their feelings aren’t important.
It’s normal to have different feelings, and the feelings of both partners are important. But it can be hard to grieve if you think that your partner doesn’t feel the same way you do.
If you and your partner can share your feelings and talk openly after your miscarriage, it can help you both through this difficult time.
Sharing your grief about your miscarriage with others
It can be very upsetting to tell family and friends about your miscarriage and your grief. It can be even harder if you hadn’t yet told people you were pregnant.
Not everyone will understand your need to acknowledge and grieve the loss of your pregnancy. Some people might even try to comfort you by saying things that minimise your loss – for example, ‘At least you know you can get pregnant’ or ‘At least you have your other children’.
But many people find that it does help to tell others. You could let close friends and family know what the pregnancy meant to you, what support you need, and how much you want to share your experience.
If you don’t feel like talking about your miscarriage, you could keep a journal of your thoughts, feelings and memories.
Getting pregnant again after miscarriage
Some couples are keen to try to get pregnant again after a miscarriage.
Your body needs time to recover physically from miscarriage, and your emotions need time too. It’s best to talk with your doctor about when you’ll be physically or emotionally ready to try again.
Causes of miscarriage
Miscarriage is common and happens for many different reasons. But it’s often hard to say exactly what has caused a miscarriage.
A common cause of miscarriage is abnormal chromosomes, which stop the embryo or fetus from developing properly.
Smoking, drinking alcohol, taking illicit drugs, and having high levels of caffeine are risk factors for people’s general health. They’re also possible risk factors for miscarriage. Looking after yourself before and during your pregnancy will give your baby the best chance of a healthy start to life.
Some couples experience multiple miscarriages. In these cases, an obstetrician might be able to offer some tests to try to find a cause.